Tag Archives: fracture

Head CT
4
Feb

Overview

Head CT is rapid and widely available for acute neurologic assessment. It detects hemorrhage fractures and mass effect. CT is the first line tool in many emergency settings.

Trauma and Hemorrhage

CT identifies acute intracranial hemorrhage and skull fractures. Rapid detection guides neurosurgical and critical care interventions. Repeat imaging monitors evolution of findings.

Chronic Disease

CT evaluates chronic sinus disease calcifications and bone pathology. It complements MRI for certain indications and surgical planning. Non contrast and contrast enhanced protocols are used as appropriate.

Limitations and Complementary Imaging

CT has limited soft tissue contrast compared with MRI. MRI provides superior evaluation of brain parenchyma and posterior fossa. Choice of modality depends on clinical question and timing.

Skull AP
4
Feb

Overview

The AP skull radiograph evaluates cranial vault symmetry and gross osseous lesions. The patient is positioned upright or supine with the detector centered to the skull. This view is used for initial assessment in trauma and suspected skull pathology.

Technique

Center the detector to include the entire skull and ensure the orbitomeatal line is perpendicular to the detector for standard AP projection. Use appropriate exposure and immobilize the head to reduce motion. Collimate to the skull to minimize dose.

Clinical Indications

AP skull is indicated for trauma suspected fracture and evaluation of lytic or sclerotic lesions. CT is preferred for detailed assessment of skull fractures and intracranial injury. Radiographs may be used when CT is unavailable.

Image Assessment

Inspect cranial vault for fractures lytic lesions and calcifications. Evaluate sutures and skull base when visible. Recommend CT for detailed evaluation of suspected intracranial or complex skull pathology.

Skull Lateral
4
Feb

Overview

The lateral skull radiograph profiles the cranial vault and facial bones to assess fractures and soft tissue calcifications. The patient is positioned true lateral with the orbitomeatal line parallel to the detector. This view complements AP imaging for comprehensive skull assessment.

Technique

Position the head in true lateral and center the detector to include the entire skull from the frontal sinus to the occiput. Use appropriate exposure and immobilize the head to minimize motion. Collimate to the skull to reduce dose.

Clinical Indications

Lateral skull is indicated for trauma suspected fracture and evaluation of sinus disease or calcifications. CT is preferred for detailed assessment of fractures and intracranial pathology. Radiographs may be used for screening or when CT is not available.

Image Assessment

Evaluate cranial vault contour suture lines and paranasal sinus aeration. Inspect for depressed fractures and soft tissue emphysema. Recommend CT for definitive assessment of suspected intracranial injury.

Mandible Panoramic
4
Feb

Overview

Panoramic radiography provides a broad overview of the mandible maxilla and dentition in a single projection. It is useful for evaluating fractures impacted teeth and dental pathology. Proper patient positioning is essential for diagnostic quality.

Technique

Position the patient with the occlusal plane aligned to the machine guide and the head stabilized. Use appropriate exposure and instruct the patient to remain still during the rotational acquisition. Remove metallic objects that may cause artifacts.

Clinical Indications

Panoramic mandible imaging is indicated for trauma dental assessment and preoperative planning. It detects mandibular fractures cysts and impacted teeth. CT or cone beam CT provides higher resolution for complex surgical planning.

Image Assessment

Assess mandibular continuity tooth root integrity and presence of radiolucent or radiopaque lesions. Evaluate condylar morphology and temporomandibular joint when included. Report findings relevant to dental or maxillofacial management.

Nasal Bones AP Lateral
4
Feb

Overview

AP and lateral nasal bone radiographs assess nasal bone alignment and detect fractures. The AP view images the nasal bones en face while the lateral view profiles displacement. These views are used for initial trauma assessment when CT is not immediately available.

Technique

Obtain AP and lateral projections with the detector centered to the nasal bones and use appropriate exposure. Ensure minimal rotation and immobilize the head to reduce motion. Remove external nasal splints or dressings when safe to do so.

Clinical Indications

Nasal bone radiographs are indicated for trauma with suspected nasal fracture and deformity. They help detect displaced fractures and septal deviation. CT provides detailed assessment for complex facial trauma and surgical planning.

Image Assessment

Assess nasal bone continuity displacement and associated soft tissue swelling. Evaluate for septal hematoma and recommend ENT consultation when indicated. Document findings relevant to cosmetic and functional outcomes.

Knee Lateral
4
Feb

Overview

The lateral knee radiograph profiles the femorotibial joint patella and soft tissues to assess effusion and fractures. The knee is flexed approximately 20 to 30 degrees for optimal visualization. This view is essential for trauma and preoperative evaluation.

Technique

Position the patient in true lateral with femoral condyles superimposed and the knee flexed. Center the detector to the joint and include the distal femur and proximal tibia. Use appropriate exposure and immobilize the limb.

Clinical Indications

Lateral knee is indicated for trauma suspected patellar fracture and evaluation of joint effusion. It complements AP and skyline views for comprehensive assessment. MRI is used for soft tissue evaluation when indicated.

Image Assessment

Evaluate patellar position and trochlear groove alignment and inspect for cortical disruption. Assess joint effusion and soft tissue swelling. Document findings relevant to orthopedic management.

Ankle AP Mortise
4
Feb

Overview

The AP mortise ankle radiograph visualizes the ankle joint with the mortise open by internally rotating the foot approximately 15 degrees. This projection displays the tibial plafond talar dome and fibular relationship. It is standard for ankle trauma and arthritis evaluation.

Technique

Internally rotate the foot to align the malleoli parallel to the detector and center to the ankle joint. Ensure the entire mortise is included and use appropriate exposure. Immobilize the limb to reduce motion artifact.

Clinical Indications

AP mortise is indicated for trauma suspected fracture and evaluation of joint congruity. It helps detect talar dome lesions and syndesmotic widening. Additional lateral and oblique views complement the mortise projection.

Image Assessment

Assess joint space symmetry and inspect for cortical disruption of the malleoli and talus. Evaluate for talar tilt and syndesmotic injury. Document findings and recommend orthopedic consultation when indicated.

Ankle Lateral
4
Feb

Overview

The lateral ankle radiograph profiles the talus calcaneus and distal tibia to assess alignment and fractures. The foot is positioned in true lateral with the medial and lateral malleoli superimposed. This view is essential for trauma and preoperative planning.

Technique

Position the ankle in true lateral and center the detector to include the distal tibia and calcaneus. Use appropriate exposure and immobilize the limb to minimize motion. Include the subtalar joint when indicated.

Clinical Indications

Lateral ankle is indicated for trauma suspected fracture and evaluation of hindfoot alignment. It complements AP mortise and oblique views for comprehensive assessment. CT is used for complex fractures and surgical planning.

Image Assessment

Evaluate talar dome integrity calcaneal alignment and posterior malleolar involvement. Inspect for joint effusion and soft tissue swelling. Report findings relevant to orthopedic management and fixation planning.

Calcaneus Axial
4
Feb

Overview

The axial calcaneus radiograph images the calcaneal body and subtalar joint to detect fractures and joint involvement. The beam is angled cephalad to project the calcaneus free of superimposition. This view is essential for suspected calcaneal injury after axial load trauma.

Technique

Position the patient supine or prone and angle the tube approximately 40 degrees cephalad to the plantar surface. Center the detector to the calcaneus and include the subtalar joint. Immobilize the foot to reduce motion artifact.

Clinical Indications

Axial calcaneus is indicated for trauma heel pain and suspected intra articular fractures. It complements lateral views for comprehensive assessment. CT is often used for detailed evaluation and surgical planning.

Image Assessment

Evaluate calcaneal height width and posterior facet integrity. Inspect for comminution and subtalar joint involvement. Document fracture pattern and recommend CT for operative planning when indicated.

Toes AP
4
Feb

Overview

The AP toes radiograph evaluates phalanges and metatarsal bases for fractures and dislocations. The toes are placed flat on the detector with slight separation. This targeted view provides high resolution assessment of small bone injuries.

Technique

Center the detector to the affected toes and collimate tightly to reduce dose. Use a small focal spot and appropriate exposure for fine detail. Immobilize the toes and use positioning aids for comfort.

Clinical Indications

AP toes are indicated for trauma localized pain and suspected fracture or dislocation. They help detect tuft fractures and joint subluxations. Additional oblique and lateral views complement the AP projection.

Image Assessment

Inspect cortical margins for fracture lines and evaluate joint spaces for subluxation. Look for foreign bodies and soft tissue swelling. Report findings and recommend follow up imaging if healing assessment is required.